title: Resident training in urology: bipolar transurethral resection of the prostate - a safe method in learning endoscopic surgical procedure.
abstract: BACKGROUND
  Modern medicine uses increasingly innovative techniques that require more and more capabilities for acquisition. In the urological department is increasing the presence of patients with lower urinary tract symptoms (LUTS) and transurethral resection of the prostate (TURP) is the standard of care in their surgical treatment. We report our surgical experience and learning curve of using bipolar plasmakinetic devices in the training of urological residents to benign prostatic hyperplasia (BPH) treatment.
  
  
  METHODS
  80 patients with benign prostatic enlargement due to BPH were enrolled in the study. TURP has been performed by three urological residents and by an expe- rienced urologist. Patients were evaluated before and 6 months after the endoscopic bipolar plasmakinetic resection using the International Prostate Symptom Score (IPSS), maximum uri- nary flow rate (Qmax), postvoid residual urine (PVR) and prostate specific antigen (PSA).
  
  
  RESULTS
  Overall 60 procedures were performed, 18 PlasmaKinetic (PK)-TURP procedures were completed by the three residents. In the other 42 cases the procedures were completed by the experienced urologist. In eight cases there was a capsular perforation and the experienced urol- ogist replaced the resident to complete the resection. No complications have been reported in the procedures completed by the senior urologist. All complications caused by the residents were man- aged intraoperatively without changing the course of the procedure. Statistical differences were observed regarding IPSS, quality of life (QoL), and PVR at 6-month follow-up when procedures completed by urological residents were compared to those completed by the senior urologist.
  
  
  CONCLUSIONS
  Bipolar device represents appropriate tools to acquire endoscopic skills. It is safe and it can be used at the first experience of BPH treatment by a resident who has not previ- ously approached this endoscopic surgical procedure.
authors.affiliation: University of L'Aquila, Department of Health Science, Mazzini Hospital, Urology Department, Teramo, Italy. delrossoa@tiscali.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Rosso
authors.forename: Stefano
authors.initials: S
authors.lastname: Masciovecchio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Paradiso Galatioto
authors.forename: Carlo
authors.initials: C
authors.lastname: Vicentini
mesh_terms: D000368:Aged; D004867:Equipment Design; D006801:Humans; D007396:Internship and Residency; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000193:education / Q000295:instrumentation / Q000379:methods*; D009929:Organ Size; D011183:Postoperative Complications / Q000453:epidemiology; D011467:Prostate / Q000473:pathology / Q000601:surgery*; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000193:education / Q000295:instrumentation / Q000379:methods*; D014563:Urodynamics
chemical_list: D017430:Prostate-Specific Antigen